Regulatory Review of Adult Day Services: Final Report - Section 1. Provisions Regarding Medications


Most states do not specify medication administration as a required service, except for adult day health care providers. The majority of states require licensed personnel to administer medications. States that permit unlicensed staff to administer medications generally required that they do so under nurse delegation provisions, though a few require only consultation with a physician or pharmacist or specific training. Examples include the following:

  • Nebraska defines medication administration as providing medications for another person according to the "five rights" (the right drug to the right recipient in the right dosage by the right route at the right time); medication provision means giving or applying a dose of medication to an individual and includes helping an individual in giving or applying the medication to himself or herself. ADS providers must ensure that medication aides and other unlicensed persons who provide medications are trained and have demonstrated the minimum competency standards specified in the relevant rules.
  • Vermont requires an adult day center to have the capacity to administer medications to its participants and requires a medication management policy that describes a center's medication management practices with due regard for state requirements, including the Vermont State Nurse Practice Act. An adult day center must provide medication management under the supervision of a registered nurse or a licensed practical nurse under the direction of a registered nurse.
  • Wisconsin specifies that if staff administer participants' medications, non-licensed staff must consult with the prescribing practitioner or pharmacist about each medication to be administered, and other conditions related to storage and documentation must be met.
  • Maine allows unlicensed employees to administer medications only if they have completed, at a minimum, an approved medication course within the previous 12 months or were employed in a health care setting during the previous 12 months where medication administration was part of their responsibilities.

Most states require providers to have written policies for medication management and administration. For example, Georgia requires adult day care programs to have a written policy for medication management designating specific staff to be authorized and trained to assist with the administration of medications and designating the program's role in the supervision of self-administered medications and/or staff-administered medications.

Many states also specify requirements related to self-administration of medications. For example, Texas requires individuals who self-administer their medications to be counseled at least once a month by licensed nursing staff to ascertain if they continue to be capable of self-administering their medications.

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